ABSTRACT
Thirty primary gastrointestinal non-Hodgkin's lymphoma treated between 1983-1990 were reviewed to reveal the efficacy of various treatment strategies. The average age at the diagnosis 53.6 (18-76) years. The histologic material were evaluated according to the Kiel classification: 22 patients had high grade malignant lymphoma (centroblastoma 8, immunoblastoma 6, lymphoblastoma 2, non classifiable 5, T-cell lymphoma 1) 8 patients low grade malignant lymphoma (lymphocytic 2, immunocytic 2, MALT lymphoma 1, centrocytoma 1, non-classifiable 1, pleomorph small cell lymphoma 1). 21 were primary gastric lymphoma, 5 involved the small intestine, 2 the ileocecal region, and 2 the large intestine. According to the Ann Arbor staging system 7 patients were stage I/E, 16 patients stage II/E, 5 patients stage III/E and 2 patients stage IV/E. Every patients underwent surgical resection. After surgical treatment high grade malignancies were treated with ProMACE-COPP (9) and CHOP-Bleo (10) polychemotherapy; low grade malignancies received VEP (5) and CVP (3) chemotherapy. 23 of 30 patients achived complete remission. The patients with low grade malignancy are in remission. All but one patients with high grade malignant gastric lymphoma achieved complete remission with a median of 37 (3-81) months relapse-free survival. Out of 5 cases in the small intestine only in 1 case was remission achieved. Histological type (Kiel) and surgical resection were the most important prognostic factors.
Subject(s)
Gastrointestinal Neoplasms/surgery , Lymphoma, Non-Hodgkin/surgery , Adolescent , Adult , Aged , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Biopsy , Combined Modality Therapy , Female , Gastrointestinal Neoplasms/classification , Gastrointestinal Neoplasms/drug therapy , Gastrointestinal Neoplasms/pathology , Humans , Lymphoma, Non-Hodgkin/classification , Lymphoma, Non-Hodgkin/drug therapy , Lymphoma, Non-Hodgkin/pathology , Male , Middle Aged , Neoplasm Staging , Prognosis , Remission InductionABSTRACT
One hundred and eleven consecutive patients with highgrade non-Hodgkin's lymphoma treated in three centres between 1983 and 1988 were analysed to assess the efficacy of different types of chemotherapy. The median age at presentation was 56.9 +/- 16.6 years. According to the Kiel classification histological subtypes were: centroblastoma (n = 45), immunoblastoma (n = 17), lymphoblastoma (n = 6), T cell lymphoblastoma (n = 9), histiocytoma (n = 2), and high grade unclassified (n = 32). Patients were clinically staged, 68 patients (61%) belong to stage I-II. and 43 had widespread disease (stage III-IV.). Remission was achieved in 81 cases [70 complete (CR) and 11 partial (PR) remission], 30 patients did not respond. The most effective modality of treatment was extended field irradiation completed with chemotherapy (81% CR, 7-year overall survival 65%) followed by ProMACE-COPP chemotherapy (67% CR, 4-year survival 40%) and CHOP-Bleo chemotherapy (65% CR, 7-year survival 25%). Age and histological subtype had no prognostic relevance, whereas clinical stage proved to have significant influence on remission and survival.
Subject(s)
Lymphoma, Non-Hodgkin/pathology , Humans , Lymphoma, Non-Hodgkin/classification , Lymphoma, Non-Hodgkin/therapy , Neoplasm StagingABSTRACT
Prognostic factors affecting the leukemic transformation were studied in 43 patients with myelodysplastic syndrome (MDS). Acute leukemia developed in 17 cases and it was nonlymphocytic leukemia in every case. No remission was achieved following antileukemic therapy and most of the cases proved to be true drug-resistant leukemia. Initial granulopenia, thrombopenia or anemia alone did not influence the occurrence of leukemic transformation but pancytopenia indicates bad prognosis. According to FAB classification especially refractory anemia with excess of blasts (RAEB) and RAEB in transformation (RAEB-T) were often followed by leukemic transformation. The granulocyte-macrophage progenitor cell (GM-CFC) content of bone marrow were also studied. The GM-CFC content was decreased in each patient. There was no correlation between GM-CFC number and leukemic transformation, the growth-pattern in agar-gel culture, however, turned out to have prognostic importance. Leukemic type of growth, namely always preceded leukemic transformation.
